| Marietta Medical Clinic Pa | |
|
401 S Marietta St Gastonia NC 28052-4331 | |
| (704) 866-8030 | |
| (704) 866-8717 |
| Full Name | Marietta Medical Clinic Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 401 S Marietta St, Gastonia, North Carolina |
| Authorized Official Name and Position | Charles K Agunobi (PHYSICIAN) |
| Authorized Official Contact | 7048668030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marietta Medical Clinic Pa 401 S Marietta St Gastonia NC 28052-4331 Ph: (704) 866-8030 | Marietta Medical Clinic Pa 401 S Marietta St Gastonia NC 28052-4331 Ph: (704) 866-8030 |
| NPI Number | 1215165659 |
|---|---|
| Provider Enumeration Date | 06/24/2009 |
| Last Update Date | 06/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215165659 | NPI | - | NPPES |
| 5950793 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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